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Looking Back on 2018 2018… Do we want to sigh? It was with great anticipation that we entered the year, predicting 2018 as the year of meaningful change, yet much remains the same. Our health insurance costs continue to rise outstandingly disproportionately to inflation—while healthcare on an individual basis has not appreciatively improved. Programs built to help physicians and facilities are not being taken advantage of to the extent they were built, while bureaucratic incumbencies continue to increase costs and slow progress. Overall, the progressive nature of the U.S. healthcare system has been frustratingly restrained with system-wide progress elusive. As…

It’s Time to Revitalize Your CDI Program—The Why and How of BPCI Clinical Documentation Improvement (CDI) programs have experienced significant transformation over the last decade. Under the new MS-DRG (Medicare Severity-Diagnosis Related Group) system—a major driver for many hospitals and health systems to invest in CDI programs—capturing CC/MCCs (complication or comorbidity and major complication or comorbidity) became the focus. Many organizations that have implemented an MS-DRG focused review program have seen success, experiencing benefits in improved provider documentation and true Case Mix Index (CMI) capture. The introduction of APR-DRG’s (All Patient Refined-Diagnosis Related Group) changed this landscape even further. Capturing…